Underage Drinking During COVID-19 Pandemic: A Systematic Review and Meta-Analysis

This systematic review (55 studies, 6 regions) and meta-analysis (18 studies, 4 regions) synthesised evidence on underage alcohol use during vs. before the COVID-19 pandemic and across early vs. later pandemic phases, integrating an umbrella review and a systematic search. Alcohol consumption generally decreased during the early pandemic, although estimates varied substantially across settings (pooled OR = 0.72, 95% CI 0.55–0.94). Regional differences were observed, with declines in all regions, but an increase in a single Australian study. Binge drinking showed nonsignificant overall change (7 estimates from 6 studies; pooled OR = 0.87, 95% CI 0.58–1.29), falling in North America (4 studies), but rising in Europe (2 studies) and Australia (1 study). Later versus earlier phase comparisons indicated a nonsignificant upward trend (3 studies; pooled OR = 1.10, 95% CI 0.89–1.35). Overall, these findings indicate heterogeneous patterns across regions and pandemic phases supporting context-specific public health responses during global disruption.